A nurse is preparing to teach the parents of a child who has cystic fibrosis. Which of the following instructions should the nurse plan to include?

Trim the fat from red meat prior to cooking.

Provide a diet high in protein and calories.

Administer pancreatic enzymes 30 min after meals.

Give the child hot foods to reduce the sense of fullness.

Answer and Explanation

The Correct Answer is B

A. Trim the fat from red meat prior to cooking. Children with cystic fibrosis often have difficulty absorbing fats due to pancreatic insufficiency, but they actually need higher fat intake to meet their increased energy demands. Trimming fat is not necessary or recommended.
B. Provide a diet high in protein and calories. Children with cystic fibrosis require a high-calorie, high-protein diet to support growth, maintain weight, and compensate for the energy lost due to chronic lung infections and malabsorption.
C. Administer pancreatic enzymes 30 min after meals. Pancreatic enzymes should be given before or with meals and snacks to aid digestion. Giving them 30 minutes after a meal reduces their effectiveness.
D. Give the child hot foods to reduce the sense of fullness. There is no evidence to support using hot foods to manage fullness in cystic fibrosis. Instead, meals should be nutrient-dense and timed to optimize digestion and absorption.

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Correct Answer is D

Explanation

A. Ham sandwich with milk. Ham is pork, which is strictly forbidden in kosher diets. Additionally, kosher law prohibits mixing meat and dairy in the same meal, making this option doubly inappropriate.
B. Bacon and cheese quiche with milk. Bacon is derived from pork and is non-kosher. The combination of meat (if using real bacon) and dairy (cheese and milk) also violates kosher dietary restrictions.
C. Shrimp salad and tomato soup with milk. Shellfish like shrimp are not kosher and are strictly avoided. Even though tomato soup and milk may be acceptable, the presence of shrimp makes this tray non-compliant with kosher laws.
D. Scrambled eggs and toast with milk. Eggs are permitted in a kosher diet as long as they do not contain blood spots, and dairy products like milk are also allowed. Since this meal contains no meat or non-kosher items, it aligns with kosher guidelines.

A. Widening pulse pressure B. Coarse lung sounds C. Muffled heart sounds D. Decreased jugular vein distention

Correct Answer is C

Explanation

A. Widening pulse pressure. This is typically associated with conditions like increased intracranial pressure or severe aortic regurgitation, not cardiac tamponade. Tamponade usually results in narrowed pulse pressure.
B. Coarse lung sounds. These may indicate fluid overload or pulmonary congestion, but they are not specific to cardiac tamponade and occur later or in different conditions.
C. Muffled heart sounds. This is a classic early sign of cardiac tamponade, caused by fluid accumulation in the pericardial sac, which dampens heart sounds on auscultation. It is part of Beck’s triad (muffled heart sounds, hypotension, and jugular vein distention).
D. Decreased jugular vein distention. In cardiac tamponade, jugular vein distention increases due to impaired venous return to the heart. Decreased JVD would be an unexpected finding in this condition.

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A nurse is preparing to teach the parents of a child who has cystic fibrosis. Which of the following instructions should the nurse plan to include?

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Naxlex Comprehensive Predictor Exams

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